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Purpose: To evaluate the efficacy of using a customized xenograft shell with a 1:1 mixture of particulate xenograft and autogenous bone for the reconstruction of horizontally deficient anterior maxillary alveolar ridges. Materials and Methods: CBCT images of the atrophic maxilla of eight patients were acquired and generated into 3D models. The data were transferred to a 3D printer for fabrication. During the surgery, xenograft blocks were manually sliced and customized on the 3D-printed models into bone shells. Then they were fixed to the atrophic site, and the gap was augmented with a 1:1 mixture of particulate xenograft and autogenous bone. Results: Clinical assessment showed no adverse effects; however, one patient exhibited wound dehiscence. The mean difference between the preoperative and 6-month postoperative CBCTs showed a net average bone gain of 4.06 mm at 2 mm from the crest and 4.34 mm at 5 mm from the crest, which was statistically significant. On the other hand, a statistically significant graft resorption of 1.41 mm at 2 mm from the crest and 2.19 mm at 5 mm from the crest was found when the mean difference between the immediate and 6-month postoperative CBCTs was calculated. Conclusions: Within the limitations of the study, the use of xenograft shells as a barrier for maxillary alveolar ridge reconstruction is a predictable technique; however, further investigations regarding the required time for graft consolidation are required. [ABSTRACT FROM AUTHOR]

ABSTRACT Aim Methods Results Conclusion To report the 10‐year clinical and radiographic outcomes of implants placed in grafted (GBR) and non‐grafted (no‐GBR) sites in a Swiss specialist private practice using hydrophilic implants with a low surface roughness flange.Fifty consecutively enrolled patients received 159 hydrophilic implants with a low surface roughness flange. A first re‐evaluation was performed 1 year after delivery of restoration (T1). An additional examination was performed at the 10‐year follow‐up (T2) including the assessment of clinical (i.e., periodontal/peri‐implant pockets probing depths (PPD) (mm), full‐mouth bleeding score (%), implant survival rate, mid‐buccal keratinized mucosa (KM) width in mm, and peri‐implant phenotype), and radiographic (i.e., marginal bone level change [ΔMBL]) outcomes. Biological, mechanical and technical complications were also recorded.Out of the initial cohort, 22 patients (9/40.9% male and 13/59% female) and 63 implants (47 with GBR, 16 without GBR), could be re‐examined at T2. Overall, ΔMBL (T2‐T1) was −0.56 ± 0.96 mm. In the GBR group, ΔMBL were significantly higher at the distal sites compared to the no‐GBR group (−0.75 ± 1.17 mm vs. −0.12 ± 1.29 mm, p = 0.045), however, in the GBR group MBL started at a higher level at T1 but were similar with the no‐GBR group at T2. Implant survival was 100% with only very few technical complications (6.3%). Mean PPD amounted to 3.84 ± 1.00 mm with significantly higher values in the GBR group (3.98 ± 1.08 mm vs. 3.45 ± 0.60 mm; p = 0.016). Nineteen implants (30.1%) were diagnosed with peri‐implant health while 44 (69.9%) presented with peri‐implant mucositis.Within the limitations of this study, favorable clinical and radiographic conditions were recorded around hydrophilic implants with a low surface roughness flange placed in pristine and augmented bone after 10 years in function. [ABSTRACT FROM AUTHOR]

Introduction: This study analyzed complication rates of guided bone regeneration (GBR) using titanium-reinforced polytetrafluoroethylene (PTFE) membranes for alveolar ridge augmentation. Material and methods: 84 patients treated with GBR using titanium-reinforced PTFE membranes (91 sites) were retrospectively analyzed. Complications such as membrane exposure and early removal were analyzed concerning patient age, defect site position, size, simultaneous vs. two-stage implant placement, smoking, and the use of bone grafts (BG) and substitutes (BS). Results: Early removal due to membrane exposure was necessary in 14/91 sites (15.4%). No correlation was found between early removal and patient age (p = 0.917). Analyzing early removal between the upper and lower jaw and between both jaws’ anterior and posterior tooth regions revealed no correlations (p = 0.381 and 0.477, respectively). Defect sites sizes of 5–6 mm exhibited the highest rate of membrane exposure, requiring early removal, accounting for 57.1% of these sites (8/14). No correlation was observed between the defect sites size and early removal (p = 0.660). Comparison of simultaneous (74 sites) vs. two-stage implant placement (16 sites) showed no correlation with early removal (p = 0.706). Membrane exposure incidence was 42.9% among smokers (27 patients, 32.1%) and 57.1% among non-smokers (57 patients, 67.9%), without correlation. No correlation was found between the type of BG and BS and early removal (p = 0.500). Conclusion: GBR using titanium-reinforced PTFE membranes is effective for alveolar ridge augmentation and has favorable long-term outcomes. Clinical relevance: Careful surgical technique and postoperative care can minimize the notable risk of PTFE membrane exposure. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methodology Results Conclusion Trial Registration Sinus floor elevation is one of the predictable techniques for augmentation of vertically deficient posterior maxillary alveolar ridges. Several biomaterials were reported to be successful for sinus augmentation, including xenografts and hydroxyapatite. The aim of this study was to compare the quality and quantity of generated bone using xenografts versus nanohydroxyapatite in sinus augmentation.Twenty‐four patients/sinuses were randomly assigned into two groups; in the control group, patients underwent sinus floor elevation and augmentation using deproteinized bovine bone (DBB), whereas in the study group, the sinus was augmented using nanohydroxy‐apatite bone (NHA). For each patient, the amount of bone height was assessed preoperatively, immediately postoperatively, and 6 months postoperatively. Furthermore, the quality of the newly formed bone was assessed via histological and histomorphometric analyses after 6 months postoperatively.Both biomaterials showed a good level of consolidation. In the study group, the mean bone height after 6 months was 11.72 ± 1.24 compared to 12.01 ± 1.16 mm in the control group which was not statistically significant (p > 0.05). The mean bone area percent of newly formed bone was 29.84% ± 6.7% for NHA group and 34.73 ± 7.9 for DBB group. Moreover, the mean percent of residual grafting material was 32.43% ± 11.53% for NHA group compared to 30.43% ± 8.27% for DBB group. Histologically, there was no significant difference between both groups regarding different parameters (p > 0.05).The two‐stage sinus floor augmentation using NHA and DBB revealed no statistically significant difference regarding both the quality and the quantity of the regenerated bone. Studies with larger samples and longer follow up are recommended.ClinicalTrials.gov identifier: NCT03184857. [ABSTRACT FROM AUTHOR]

The article provides an evidence-based review of different bone grafting materials used in sinus floor elevation procedures, including autologous bone, bovine bone, and allografts. It discusses the clinical outcomes and recommendations based on systematic reviews and meta-analyses. The text emphasizes the importance of biomaterial selection and formulation for optimal outcomes in dental implant treatment. It also covers topics such as the use of platelet-rich fibrin and the impact of residual bone height on implant placement in the sinus area. This comprehensive review offers valuable insights for dental professionals and researchers in the field of oral implantology. [Extracted from the article]

Aim: To assess whether guided bone regeneration (GBR) treatment of peri‐implantitis‐related bony defects could improve healing compared to open flap debridement (OFD) at 36 months. Materials and Methods: In a multi‐centre, randomized clinical trial, 32 individuals received OFD (control group [CG]) and 34 GBR treatment (test group [TG]). Radiographic defect fill (RDF), probing pocket depth (PPD), bleeding on probing (BOP) suppuration (SUP), mucosal recession (MREC) and patient‐reported outcomes (PROs) were evaluated at 36 months. Results: Fifty individuals attended a supportive peri‐implant therapy program and completed the 36‐month follow‐up. GBR treatment resulted in an RDF of 2.13 ± 1.26 mm compared to 1.64 ± 1.54 mm following OFD (p =.18). No difference was found in PPD, BOP, SUP, REC or PROs between the groups. Successful treatment (no additional bone loss, PPD ≤ 5 mm, no BOP and no SUP) was achieved in 46.2% in TG and 20% in CG (p =.053). Treatment results obtained at 12 months were generally maintained up to 36 months. No significant changes were noticed between 12 and 36 months. Conclusions: At 36 months, treatment results obtained at 1 year were sustained following both GBR and OFD in patients attending supportive peri‐implant therapy. GBR resulted in more RDF and higher composite treatment success rate than OFD (ClinicalTrials.gov Identifier [NCT02375750]). [ABSTRACT FROM AUTHOR]

This study aims to evaluate the clinical outcomes of using demineralized, freeze-dried allogeneic bone blocks (DFDABB) combined with the periosteal vertical mattress suture (PVMS) technique for the reconstruction of severe horizontal alveolar bone deficiencies in the maxilla. In continuous horizontal maxillary defects cases, bone augmentation was performed using DFDABB and deproteinized bovine bone matrix (DBBM) filling the interstice. Subsequently, a resorbable collagen membrane was carefully placed over the graft surface, and both the membrane and bone graft were firmly secured using the PVMS technique. Linear changes were assessed through superimposed cone-beam computerized tomography scans obtained before the operation and after a healing period of 6–10 months. A total of 7 female patients with 10 bone blocks and 13 implants were included in this study. One of the wounds was slightly ruptured postoperatively without infection, and all implants showed successful osseointegration. The average alveolar ridge width at a point 5 mm below the crest was 4.52 ± 2.03 mm before bone graft and 9.79 ± 1.57 mm after implantation with an average increase of 5.26 ± 1.97 mm. Similarly, at a point 10 mm below the crest, the pregraft alveolar ridge width measured 7.23 ± 3.60 mm, and postimplantation, it expanded to 11.81 ± 2.90 mm, showing an average gain of 4.58 ± 2.01 mm. This case series demonstrates the successful application of DFDABB combined with the PVMS technique to achieve adequate bone width for implantation at severe continuous horizontal bone deficiency of the maxilla. DFDABB with the PVMS technique resulted in superior horizontal bone gain during maxillary bone augmentation with horizontal continuity deficiency. However, further studies are necessary to validate these findings. [ABSTRACT FROM AUTHOR]

Copyright of West China Journal of Stomatology is the property of Sichuan University, West China College of Stomatology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ABSTRACT Background Materials and Methods Results Conclusion It has been suggested that 1–2 mm of bone width at the buccal and lingual aspect is required for a successful long‐term implant outcome. Low levels of evidence support this minimum threshold of bone width. This prospective study aimed at evaluating the outcome of implants placed in alveolar ridges with limited bucco‐oral dimensions.One‐hundred implants (dia. 3.5 mm) were placed in 28 patients with narrow alveolar ridge dimensions (<4.5 mm width) without augmentation procedures and conventionally loaded. Intra‐oral radiographs were taken at implant placement and abutment connection and at 1, 2, 3, 5 and 10 years of follow‐up. At the 10‐year follow‐up (21 patients; 75 implants), full‐mouth periodontal charting was performed, and the peri‐implant keratinized tissue width and attachment type were recorded. Two calibrated periodontists analysed the peri‐implant bone changes.After 10 years, all implants showed successful osseointegration and a cumulative survival rate of 100%. The implants were placed 0.85 mm ± 0.89 mm subcrestally. After 10 years, the marginal bone was located 1.59 ± 2.11 mm apical to the implant shoulder. Throughout this period of follow‐up, the mean annual marginal bone loss was 0.094 mm. Furthermore, 84% of implants in 72% of patients presented with bleeding on probing.After 10 years of functional loading, implants placed in alveolar ridges with limited bucco‐oral dimensions (≤4.5 mm) exhibited only minimum marginal bone loss. [ABSTRACT FROM AUTHOR]

Periosteal expansion osteogenesis (PEO) is a technique for augmenting bone by creating a gradual separation between the bone and periosteum. This study assessed PEO‐induced bone formation around the femurs of rats using a dynamic frame device (DFD), consisting of a shape memory membrane made of polyethylene terephthalate (PET) formed into a tubular shape. The DFDs, consisting of a PET membrane coated with hydroxyapatite (HA)/gelatin on the bone‐contact surface, were inserted between the periosteum and bone of the femurs of rats. In the experimental group, DFDs were suture‐fixed to the femur with 4–0 Vicryl Rapid; in the control group, 4–0 silk thread was used for fixation. Five rats per group were euthanized at intervals of 3, 5, and 8 weeks postoperatively. Bone formation was evaluated via micro‐CT imaging, histomorphometry, and histological analysis. Morphological analysis revealed new bone between the femur and the periosteum, expanded by the DFD, in all groups. The mean values of new bone were 0.30 mm2 proximally, 0.18 mm2 centrally, and 0.82 mm2 distally in the control group, compared to 1.05 mm2 proximally, 0.27 mm2 centrally, and 0.84 mm2 distally in the experimental group. A significant difference in new bone was observed in the proximal region of the experimental group. Histological examination showed that a single layer of newly formed neoplastic bone was noted on the cortical bone surface across all sites. The proximal portion displayed a bone marrow cavity at the center, encircled by a thick bone cortex with a layered structure. New bone formation was notable between existing cortical bone and the periosteum, particularly at both ends of the DFD. The use of PET in PEO was a viable option for achieving ideal bone morphology. [ABSTRACT FROM AUTHOR]

Purpose: To histologically and radiographically investigate the effect of plasma rich in growth factor (PRGF) mixed with bone grafts on ossification in the early period. Materials and Methods: A total of 12 New Zealand male rabbits (weighing between approximately 2.5 to 3 kg) were included in this study. Subjects were randomly divided into two sets of groups: control and experiment. Autograft, DFDBA (demineralized freeze-dried bone allograft), and DBBM (deproteinized bovine bone mineral) were applied to different defects in the control groups, and autograft + PRGF, DFDBA + PRGF, and DBBM + PRGF were applied in the experimental groups. All subjects were euthanized 28 days after surgery. The volumes of the bone, new connective tissue, and new capillaries were evaluated stereologically, and the bone density in the defects was investigated radiographically. Results: Regarding the stereologic evaluation, the volumes of the bone and capillaries were significantly higher in the experimental groups than in the control groups. In contrast, the connective tissue volume was considerably lower (P < .001, in all groups). Similarly, radiographic examinations showed that the bone density measurements in the experimental groups were higher than in the control groups. However, these differences were statistically significant only between the DFDBA + PRGF and DFDBA groups (P < .011). Conclusions: The present study provides evidence that the addition of PRGF to autograft, DFDBA, and DBBM enhances osteogenesis in the early period compared to using these grafts alone. It also accelerates the remodeling of connective tissue to bone in defects. [ABSTRACT FROM AUTHOR]

Cases of relatively safe dental implant treatment in patients with low-volume bisphosphonate (BP) have been gradually reported. Although bone augmentation is commonly used when the bone volume is insufficient for implant placement, the studies and case reports regarding the safety of bone augmentation in patients treated with BP remain insufficient. Herein, we report a case wherein bone augmentation was performed after BP treatment with bone healing realized according to imaging, and we review the literature regarding BP and bone augmentation. A 67-year-old Japanese woman requested implant treatment for a hopeless lower right second molar. She had been taking minodronic acid hydrate (50 mg/4 wk) for 18 months to treat steroid-induced osteoporosis. After obtaining informed consent, tooth extraction and bone augmentation within the extraction socket were performed. The tooth was extracted atraumatically to preserve the surrounding alveolar bone, and the extraction socket was intensely curetted. Subsequently, the socket was filled with carbonate apatite granules and covered with a biodegradable membrane, and the wound was sutured without tension. Although protracted wound healing without any symptoms of infection was observed, the wound healed completely. No clinical symptoms were observed, the color of the mucosa at the site was healthy, and imaging findings at 6 months postoperation indicated that osteogenesis had progressed uneventfully. [ABSTRACT FROM AUTHOR]

Purpose: To review and compare the available literature on bone regeneration using titanium mesh and map the current evidence on bone gain outcomes and complications while comparing this scaffold with collagen membranes. Materials and methods: A comprehensive electronic and manual search was performed to identify randomised and non-randomised prospective controlled clinical trials that involved the use of titanium mesh in at least one arm, with outcomes including complications and vertical and/or horizontal bone gain. The focused questions were defined as follows: What are the outcomes of using titanium mesh in ridge augmentation compared to other types of barrier membrane, and what is the complication rate (membrane exposure and infection) when titanium mesh is used in these procedures? Results: A total of 22 articles were included in the qualitative analysis. Overall, the studies that measured bone gain resulted in 3.36 mm vertical (196 subjects; 95% confidence interval 2.44 to 4.64 mm, range 1.4 to 5.7 mm) and 3.26 mm horizontal augmentation (81 subjects; 95% confidence interval 2.93 to 3.63 mm, range 2.6 to 3.7 mm), with variability among studies. The most commonly noted complication was mesh exposure, regardless of the type of mesh used, and the second most common was graft failure. The overall pooled complications rate reported in clinical trials was 10.8%. The meta-analysis comparing titanium mesh and collagen membranes, controlling for the type of bone regeneration (staged or simultaneous with implant placement), failed to show a significant difference in horizontal bone gain between the two techniques. Conclusions: Within the limitations of the present study and acknowledging the heterogeneity among the articles included, titanium mesh can serve as a feasible protective scaffold for bone regeneration with a relatively acceptable complication rate and in defects requiring around 4 mm 3D reconstruction. Data on patient-reported outcomes were scarce. [ABSTRACT FROM AUTHOR]

Copyright of Implantologie is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims: (1) To assess the effectiveness of the Sausage Technique™ when applied for lateral bone augmentation by multiple experienced clinicians; (2) To identify risk indicators for a poor outcome and to assess the need for adjunctive surgery. Materials and Methods: All patients who had been treated with the Sausage Technique™ for lateral bone augmentation by three experienced surgeons between January 2019 and December 2021 were included in a retrospective case series. The Sausage Technique™ technique includes the use of autogenous bone chips and deproteinized bovine bone mineral (1:1 ratio), covered with a stretched and pinned collagen membrane. The increase in alveolar width between the pre‐operative situation and 9 months was assessed at different levels on superimposed cone‐beam CT scans. Results: Twenty‐five augmentations performed in 25 patients (17 males, 8 females, mean age 51 years) were available for evaluation. Mean alveolar width increased from 4.35 to 7.43 mm at 3 mm below the crest. The mean increase of 3.08 mm (95% CI 2.10–4.06; p < 0.001) was significant. The outcome of non‐containing single implant sites was significantly worse than the outcome of other sites (MD 2.67 mm; p = 0.008). The need for regrafting was 4% and the need for soft tissue augmentation was 48%. Twenty percent of the patients needed soft tissue augmentation due to a lack of keratinized mucosa width, and 32% due to a lack of buccal convexity. The former was mainly needed at multiple implant sites, whereas the latter was mainly required at single implant sites. All implant survived and remained healthy until the final follow‐up. Conclusion: The Sausage Technique™ is an effective bone augmentation technique. Non‐containing single implant sites were associated with a poor outcome and adjunctive soft tissue augmentation was needed in about half of the patients. [ABSTRACT FROM AUTHOR]

Impiant-supported réhabilitation in high-risk patients poses significant challenges for the dental team. The presence of comorbidities and increased infection risk can, for example, lead to a higher risk of implant loss. For the therapy to be completed with as few compli-cations as possible, special anamnesis, detailed diag-nostics, and a risk analysis based on those findings are indispensable. The aim of all considerations is to keep the risk of infection for the patient with a disease his-tory to a minimum and to strive for an appropriate functional and esthetic therapeutic success. Particu-larly in the esthetic zone, in addition to the general health risks of the surgical procedure, esthetic aspects are increasingly taken into account in planning. The present article describes the implant-prosthetic re-placement of a single anterior tooth in a dialysis pa-tient. Several aspects (regular dialysis, missing buccal lamella, high smile line, functional risk) increased the risk of complications in this case. (Int J Esthet Dent 2024;19:152-169) [ABSTRACT FROM AUTHOR]

The pneumatization of the maxillary sinus poses challenges for oral implantologists due to its natural expansion into the maxillary bone, often exacerbated by tooth loss. This reduces available bone for implant placement in the posterior maxilla, necessitating augmentation techniques to facilitate successful implantation. This article presents the case of a 23-year-old female with severe tooth decay in the left maxilla, desiring implant replacement. Cone-beam computed tomography (CBCT) revealed inadequate bone height (3.3 mm) complicated by sinus pneumatization. Surgical intervention involved tooth extraction followed by direct sinus augmentation with a bone graft to stimulate osteogenesis. Simultaneously, an implant was placed. Follow-up CBCT examination occurred at the 4-month interval. At the 4-month follow-up, CBCT examination demonstrated a significant increase in vertical bone height to 12.4 mm, indicating successful bone regeneration and implant stability. The case highlights the importance of a comprehensive diagnostic approach and strategic surgical planning in managing sinus pneumatization-related challenges for implant placement. Direct sinus augmentation combined with bone grafting proved effective in achieving sufficient bone height for implantation. This underscores the significance of appropriate therapeutic interventions and postoperative monitoring for favorable outcomes in such cases. [ABSTRACT FROM AUTHOR]

Vertical bone augmentation to create host bone prior to implant placement is one of the most challenging regenerative procedures. The objective of this study is to evaluate the capacity of a UV-photofunctionalized titanium microfiber scaffold to recruit osteoblasts, generate intra-scaffold bone, and integrate with host bone in a vertical augmentation model with unidirectional, limited blood supply. Scaffolds were fabricated by molding and sintering grade 1 commercially pure titanium microfibers (20 μm diameter) and treated with UVC light (200-280 nm wavelength) emitted from a low-pressure mercury lamp for 20 min immediately before experiments. The scaffolds had an even and dense fiber network with 87% porosity and 20-50 mm inter-fiber distance. Surface carbon reduced from 30% on untreated scaffold to 10% after UV treatment, which corresponded to hydro-repellent to superhydrophilic conversion. Vertical infiltration testing revealed that UV-treated scaffolds absorbed 4-, 14-, and 15-times more blood, water, and glycerol than untreated scaffolds, respectively. In vitro, four-times more osteoblasts attached to UV-treated scaffolds than untreated scaffolds three hours after seeding. On day 2, there were 70% more osteoblasts on UV-treated scaffolds. Fluorescent microscopy visualized confluent osteoblasts on UV-treated microfibers two days after seeding but sparse and separated cells on untreated microfibers. Alkaline phosphatase activity and osteocalcin gene expression were significantly greater in osteoblasts grown on UV-treated microfiber scaffolds. In an in vivo model of vertical augmentation on rat femoral cortical bone, the interfacial strength between innate cortical bone and UV-treated microfiber scaffold after two weeks of healing was double that observed between bone and untreated scaffold. Morphological and chemical analysis confirmed seamless integration of the innate cortical and regenerated bone within microfiber networks for UV-treated scaffolds. These results indicate synergy between titanium microfiber scaffolds and UV photofunctionalization to provide a novel and effective strategy for vertical bone augmentation.

Aims: The aim of this randomized controlled clinical trial was to compare the gene expression, micro‐CT, histomorphometrical analysis between biphasic calcium phosphate (BCP) of 70/30 ratio and deproteinized bovine bone mineral (DBBM) in sinus augmentation. Materials and Methods: Twenty‐four patients in need for sinus floor augmentation through lateral approach were randomized into BCP 70/30 ratio or DBBM. After at least 6 months of healing, a total of 24 bone specimens were collected from the entire height of the augmented bone at the area of implant placement and underwent micro‐CT, histomorphometric and gene expression analysis. The 12 bone specimens of BCP 70/30 ratio were equally allocated to micro‐CT and histologic analysis (test group, n = 6) and gene expression analysis (test group, n = 6). Similarly, the 12 bone specimens of DBBM were also allocated to micro‐CT and histologic analysis (control group, n = 6) and gene expression analysis (control group, n = 6). The newly formed bone, remaining graft materials and relative change in gene expression of four target genes were assessed. Results: The micro‐CT results showed no statistically significant difference in the ratio of bone volume to total volume (BV/TV ratio) for the two groups (BCP 41.51% vs. DBBM 40.97%) and the same was true for residual graft material to total volume (GV/TV ratio, BCP 9.97% vs. DBBM 14.41%). Similarly, no significant difference was shown in the histological analysis in terms of bone formation, (BCP 31.43% vs. DBBM was 30.09%) and residual graft area (DBBM 40.76% vs. BCP 45.06%). With regards to gene expression, the level of ALP was lower in both groups of bone grafted specimens compared with the native bone. On the contrary, the level of OSX, IL‐1B and TRAP was higher in augmented bone of both groups compared with the native bone. However, the relative difference in all gene expressions between BCP and DBBM group was not significant. Conclusions: The BCP, HA/β‐TCP ratio of 70/30 presented similar histological and micro‐CT outcomes in terms of new bone formation and residual graft particles with DBBM. The gene expression analysis revealed different gene expression patterns between augmented and native bone, but showed no significant difference between the two biomaterials. [ABSTRACT FROM AUTHOR]

Objective: The limitations of spontaneous bone healing underscore the necessity for exploring alternative strategies to enhance bone regeneration in maxillary radicular cyst cases. This retrospective study aimed to assess the impact of a bone substitute material (i.e., Bio-Oss) on bone volume regeneration following maxillary radicular cyst enucleation using cone-beam computed tomography (CBCT). Materials and methods: Seventy-three patients with maxillary radicular cysts were divided into two groups: one undergoing guided bone regeneration (GBR) with Bio-Oss and absorbable collagen membrane (n = 35), and the other receiving cyst excision alone (n = 38). Volumetric measurements using Amira software on CBCT scans evaluated bone regeneration, with cystic lesion shrinkage rates calculated. Intergroup comparisons utilized independent sample t-tests (P < 0.05), and linear regression analysis assessed the influence of preoperative cyst volume and group on bone healing. Results: Both groups showed similar success rates in bone formation at the 12-month follow-up, with no significant differences between them (mean (SD), control: 75.16 (19.17) vs. GBR: 82 (20.22), P > 0.05). Linear regression analysis revealed a negative correlation between preoperative cyst volume and bone regeneration in both groups (P < 0.05). Conclusion: Bio-Oss may not significantly enhance bone augmentation in maxillary radicular cysts. In addition, preoperative cyst volume negatively affected the shrinkage rate of cystic lesions. Clinical relevance: Clinicians should consider patient-specific factors such as anatomy and lesion size when determining the need for bone substitute materials. Future research could focus on optimizing treatment protocols and alternative regenerative strategies to improve patient outcomes in maxillary cyst cases. [ABSTRACT FROM AUTHOR]

Dental implant placement frequently requires preceding bone augmentation, for example, with hydroxyapatite (HA) or β-tricalcium phosphate (β-TCP) granules. However, HA is degraded very slowly in vivo and for β-TCP inconsistent degradation profiles from too rapid to rather slow are reported. To shorten the healing time before implant placement, rapidly resorbing synthetic materials are of great interest. In this study, we investigated the potential of magnesium phosphates in granular form as bone replacement materials. Spherical granules of four different materials were prepared via an emulsion process and investigated in trabecular bone defects in sheep: struvite (MgNH 4 PO 4 ·6H 2 O), K-struvite (MgKPO 4 ·6H 2 O), farringtonite (Mg 3 (PO 4) 2) and β-TCP. All materials except K-struvite exhibited promising support of bone regeneration, biomechanical properties and degradation. Struvite and β-TCP granules degraded at a similar rate, with a relative granules area of 29% and 30% of the defect area 4 months after implantation, respectively, whereas 18% was found for farringtonite. Only the K-struvite granules degraded too rapidly, with a relative granules area of 2% remaining, resulting in initial fibrous tissue formation and intermediate impairment of biomechanical properties. We demonstrated that the magnesium phosphates struvite and farringtonite have a comparable or even improved degradation behavior in vivo compared to β-TCP. This emphasizes that magnesium phosphates may be a promising alternative to established calcium phosphate bone substitute materials. [Display omitted] • Fabrication of three different magnesium phosphate granules (struvite, K-struvite, farringtonite) via emulsion technique. • Magnesium phosphate granules show an accelerated degradation behavior (K-struvite > farringtonite > struvite) in sheep. • Magnesium phosphate granules appear highly promising as bone substitutes for future clinical use. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to create a three-dimensional histological reconstruction through the AI-assisted classification of tissues and the alignment of serial sections. The secondary aim was to evaluate if the novel technique for histological reconstruction accurately replicated the trabecular microarchitecture of bone. This was performed by conducting micromorphometric measurements on the reconstruction and comparing the results obtained with those of microCT reconstructions. Methods: A bone biopsy sample was harvested upon re-entry following sinus floor augmentation. Following microCT scanning and histological processing, a modified version of the U-Net architecture was trained to categorize tissues on the sections. Detector-free local feature matching with transformers was used to create the histological reconstruction. The micromorphometric parameters were calculated using Bruker's CTAn software (version 1.18.8.0, Bruker, Kontich, Belgium) for both histological and microCT datasets. Results: Correlation coefficients calculated between the micromorphometric parameters measured on the microCT and histological reconstruction suggest a strong linear relationship between the two with p-values of 0.777, 0.717, 0.705, 0.666, and 0.687 for BV/TV, BS/TV, Tb.Pf Tb.Th, and Tb.Sp, respectively. Bland–Altman and mountain plots suggest good agreement between BV/TV measurements on the two reconstruction methods. Conclusions: This novel method for three-dimensional histological reconstruction provides researchers with a tool that enables the assessment of accurate trabecular microarchitecture and histological information simultaneously. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical outcome of the transalveolar approach with the small segmentation method for inclined maxillary sinus floor elevation. Methods: Sixty‐one patients with an inclined maxillary sinus floor (tilt angle ≥ 10°) and insufficient residual bone height in the posterior maxilla were included and grouped according to the tilt angle of the sinus floor, with group A having patients with the tilt angle ≥ 10° and ≤ 30° and group B having patients with the tilt angle > 30°. After completing sinus membrane elevation and bone augmentation using bone substitute materials, the implants were inserted at the same appointment, and the restoration was completed after 5–6 months of osseointegration. The preoperative sinus floor level and sinus floor elevation achieved postoperatively were assessed and recorded. At pre‐ and post‐operative timepoints, the sagittal plane of the cone beam computed tomography was used to evaluate the bone height changes at the peak, middle and valley points in the slope segment intended for implant implantation. Results: Osseointegration was evident in all 61 patients, and the final restoration was completed with functional loading. After assessing the normality and homogeneity of variance, two‐sample t‐test or nonparametric tests were employed to estimate the differences in the bone height changes. The degrees of freedom (df) for this analysis were 59. The elevation attained at the middle point in groups A and B were 6.71 ± 1.38 and 5.75 ± 1.56 mm, respectively, demonstrating a significant difference (p < 0.05). Furthermore, at the peak and valley points, group A exhibited bone height changes of 5.79 ± 1.74 and 6.06 ± 1.45 mm, respectively, compared to group B with changes measuring 4.63 ± 2.18 and 5.58 ± 2.39 mm, respectively, with no significant difference in the two groups (p ≥ 0.05). The prevalence of intraoperative sinus membrane perforation was assessed using the chi‐square test. It was found that four cases in group A and five cases in group B experienced sinus membrane perforation, with no significant difference in the two groups (p ≥ 0.05, df = 1). Conclusion: The transalveolar approach using the small segmentation method suggests a promising approach for elevating the inclined maxillary sinus floor. [ABSTRACT FROM AUTHOR]

Featured Application: This present systematic review aimed to provide new insights into the development of 3D-printed scaffolds to promote dental implant placement. Background: Regenerative medicine in dentistry involves tissue engineering applications suitable for the unique oral environment. In this regard, advances in computer-aided technology have facilitated the creation of 3D scaffolds using cone beam computed tomography (CBCT). This review aimed to investigate whether 3D-printed scaffolds can be effectively used to achieve ridge preservation and/or predictable vertical and horizontal bone augmentation, ensuring successful outcomes for dental implant placement. Methods: A comprehensive search was conducted across six electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, Ovid) to identify relevant studies according to specific eligibility criteria, following the PRISMA guidelines. Two independent reviewers screened and selected studies, performed data extraction, and assessed the risk of bias using the Cochrane tool for randomized clinical trials and the Newcastle–Ottawa Scale for non-randomized clinical trials. Results: The initial search yielded 419 articles, which were subsequently screened to remove duplicates. After evaluating 293 articles based on title and abstract, 10 studies remained for full-text assessment. Ultimately, only three studies met all the pre-established eligibility criteria. Conclusions: The studies included in this systematic review showed that the use of multidimensional customized scaffolds appears to promote dental implant placement. Nevertheless, despite the positive reported effects, further well-designed randomized clinical trials are necessary to determine the special characteristics of the optimal 3D-customized scaffold. [ABSTRACT FROM AUTHOR]

Background. The clinical teaching of esthetic implant-supported restoration of the atrophic maxilla is challenging due to the complexity and unpredictability of bone and soft tissue augmentation. The traditional problem-based learning and case-based learning method (PBL-CBL method) with a full digital workflow (digital PBL-CBL method) provides the students a chance to view clinical cases in a more accurate and measurable way. The aim is to evaluate the effectiveness of the new digital PBL-CBL method in teaching complex implant cases in esthetic area. Materials & Methods. A full digital workflow of dental implant therapy was established for patients with severely atrophic anterior maxilla. The digital data of cases done in the new workflow was used as teaching materials in digital PBL-CBL teaching. Fiftyfour postgraduate students were randomly selected and divided into three groups, including traditional PBL-CBL group (students taught in a PBL-CBL method with no digital cases), digital PBL-CBL group (students taught in a PBL-CBL method with full digital cases) and control group (students taught in didactic teacher-centered method). After training for three months, a study of the students' opinions on the corresponding teaching method was carried out through a feedback questionnaire. A theory test was used to evaluate students' mastery of knowledge about tissue augmentation and esthetic implant restoration. A case analysis was used to determine whether students could apply the knowledge to problem solving. Results. The digital PBL-CBL method resulted in a higher rate of satisfaction than the traditional PBL-CBL method and the didactic teacher-centered method in all items except for "This approach decreases extracurricular work". Case analysis scores of the digital PBL-CBL group were significantly higher than that of the traditional PBLCBL group and the control group. For the theory test, the digital PBL-CBL group (61.00±6.80) but not traditional PBL-CBL group (55.22±9.86) obtained a significant higher score than the control group (45.11 ± 12.76), although no significant difference was found between the digital PBL-CBL group and the traditional PBL-CBL group. Conclusion. Compared with other methods, students taught with the digital PBL-CBL method showed higher satisfaction and better performance in acquisition of academic knowledge and ability in solving practical clinical problems. The digital PBL-CBL method provided a promising alternative for teaching complex implant cases at the anterior maxilla. [ABSTRACT FROM AUTHOR]

Abstract Objectives To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate. Materials and methods Electronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0. Results 24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants’ survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction. Conclusion Recent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality. Clinical relevance The ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests.

Abstract Background Adherence to antibiotic recommendations and safety aspects of restrictive use are important components when combating antibiotic resistance. The primary aim of this study was to assess the impact of national guidelines on antibiotic prescriptions for bone augmentation procedures among dentists working at three specialized clinics. The secondary aim was to assess the occurrence of postoperative infections. Methods Medical charts of 400 patients treated with bone augmentation were reviewed: 200 in the years 2010–2011 and 200 in 2014–2015. The Swedish national recommendations for antibiotic prophylaxis were published in 2012. Results There was a wide variation in antibiotic regiments prescribed throughout the study. The number of patients treated with antibiotic prophylaxis in a single dose of 2 g amoxicillin, and treated as advocated in the national recommendations, was low and decreasing between the two time periods from 25% (n = 50/200) in 2010–2011 to 18.5% (n = 37/200) in 2014–2015. The number of patients not given any antibiotics either as a prophylactic single dose or during the postoperative phase increased (P

The aim of this study was to evaluate by means of coherence optical tomography (OCT) two synthetic bone augmentation materials based on hydroxyapatite and to quantify the degree of filling of the experimental cavities created one month and two months after their creation. We made 4 groups of 5 Whistar rats on which we created experimental cavities in calvaria and in the upper maxillary. Samples were obtained after one months for two study group and after two months for the other two. After obtaining the images from the optical coherence tomography examination, they were analysed with the ImageJ software. The results provided important information related to the healing pattern of the experimental cavities, the degree of their filling with newly formed bone tissue, but also about the presence of residual particles of synthetic bone graft materials.The increased refractive index of a synthetic bone augmentation material is an important advantage in assessing by OCT the presence of material particles in a bone cavity. The maxillary bone anatomy due to its convexities made more difficult the evaluation of the samples from this area compared to the flat surfaces offered by the calvaria samples. Optical coherence tomography remains a promising method for the evaluation of new-forming bone tissue when synthetic bone graft materials are used, both for research evaluation in order to compare different materials, but also for the potential to be used in clinical activity as well.

Abstract Introduction Bone augmentation procedures are established tools for reshaping the alveolar ridge and increasing bone volume. Different approaches are being used to measure postoperative bone volume gain. This study aimed to develop an objective and automated volume measurement tool equally as precise as manual slice-by-slice annotation. Materials and methods To evaluate the proposed workflow, we performed an in vitro study with 20 pig mandibles that were grafted using three different grafting techniques—autogenous full block, split block bone and shell augmentation. The pig jaws were scanned pre- and postoperatively using an intraoral scanner. The resulting surface files (baseline, full block, split block, shell) were processed using the new volume-measuring workflow as well as using manual slice-by-slice annotation at baseline (t0) and at 6 months (t1) using the same population. Two TOSTs (Test of One-Sided Significance) and NHSTs (Null Hypothesis Significance Test) were used to compare the two workflows. The intra-rater reliability between t0 and t1 was determined using intraclass correlation coefficients. Results The mean difference for the full block augmentation technique was − 0.015 cm3 (p

Endochondral ossification (ECO) plays an integral part in bone augmentation, which undergoes sequential processes including mesenchymal stem cells (MSC) condensation, chondrocyte differentiation, chondrocyte hypertrophy, and mineralized bone formation. Thus, accelerating these steps will speed up the osteogenesis process through ECO. Herein, inspired by the marine mussels' adhesive mechanism, a bioactive glass-dopamine (BG-Dopa) hydrogel was prepared by distributing the micro-nano BG to aldehyde modified hyaluronic acid with dopamine-modified gelatin. By in vitro and in vivo experiments, we confirm that after implanting in the bone augmentation position, the hydrogel can adhere to the cortical bone surface firmly without sliding. Moreover, the condensation and hypertrophy of stem cells were accelerated at the early stage of ECO. Whereafter, the osteogenic differentiation of the hypertrophic chondrocytes was promoted, which lead to accelerating the late stage of ECO process to achieve more bone augmentation. This experiment provides a new idea for the design of bone augmentation materials.

Objectives: To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate. Materials and methods: Electronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0. Results: 24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants' survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction. Conclusion: Recent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality. Clinical relevance: The ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests. [ABSTRACT FROM AUTHOR]

Bone allografts are widely used as osteoconductive support to guide bone regrowth. Bone allografts are more than a scaffold for the immigrating cells as they maintain some bioactivity of the original bone matrix. Yet, it remains unclear how immigrating cells respond to bone allografts. To this end, we have evaluated the response of mesenchymal cells exposed to acid lysates of bone allografts (ALBA). RNAseq revealed that ALBA has a strong impact on the genetic signature of gingival fibroblasts, indicated by the increased expression of IL11, AREG, C11orf96, STC1, and GK—as confirmed by RT-PCR, and for IL11 and STC1 by immunoassays. Considering that transforming growth factor-β (TGF-β) is stored in the bone matrix and may have caused the expression changes, we performed a proteomics analysis, TGF-β immunoassay, and smad2/3 nuclear translocation. ALBA neither showed detectable TGF-β nor was the lysate able to induce smad2/3 translocation. Nevertheless, the TGF-β receptor type I kinase inhibitor SB431542 significantly decreased the expression of IL11, AREG, and C11orf96, suggesting that other agonists than TGF-β are responsible for the robust cell response. The findings suggest that IL11, AREG, and C11orf96 expression in mesenchymal cells can serve as a bioassay reflecting the bioactivity of the bone allografts. [ABSTRACT FROM AUTHOR]

Additive manufacturing techniques are being used in the medical field. Orthopedic hip prostheses and denture bases are designed and fabricated based on the patient's computer-aided design (CAD) data. We attempted to incorporate this technique into dental implant bone augmentation. Surgical simulation was performed using patient data. Fourteen patients underwent bone augmentation using a selective laser melting (SLM) titanium mesh plate. The results showed no evidence of infection in any of the 14 patients. In 12 patients, only one fixation screw was used, and good results were obtained. The SLM titanium mesh plate was good adaptation in all cases, with bone occupancy greater than 90%. The average bone resorption of the marginal alveolar bone from the time of dental implant placement to the time of the superstructure placement was 0.69 ± 0.25 mm. Implant superstructures were placed in all cases, and bone augmentation with SLM titanium mesh plates was considered a useful technique. [ABSTRACT FROM AUTHOR]

The current scientific knowledge and guidelines in bone and soft tissue augmentation suggest the use of staged surgical workflows as the gold standard of regenerative procedures during implant therapy. In this context, the process is always the same, regardless of the techniques applied: an alternate series of surgical acts that follow one another after the completion of a specific period of osseointegration or graft maturation. As a result, the overall surgical treatment is often long and invasive and induces scar tissue formation. This article proposes a novel, fast, and less-invasive biphasic protocol with the use of a well-documented cortical barrier mounted on healing screws that are further replaced by customized abutments at an early second stage. Two cases are reported, one for an upper maxillary edentulous area and the other for a mandibular, with a total of four implants placed. The results at 4 months postop showed an optimal soft tissue configuration for both cases, with adequate cervical profile generation and a sufficient supracrestal complex height above the implant platforms. Significant bone gains were also recorded through CBCT data collection, either with alveolar width measurements on axial slices, the superposition of pre-op and post-op datasets, or 3D visualization after bone volume segmentation. [ABSTRACT FROM AUTHOR]

Background: Adherence to antibiotic recommendations and safety aspects of restrictive use are important components when combating antibiotic resistance. The primary aim of this study was to assess the impact of national guidelines on antibiotic prescriptions for bone augmentation procedures among dentists working at three specialized clinics. The secondary aim was to assess the occurrence of postoperative infections. Methods: Medical charts of 400 patients treated with bone augmentation were reviewed: 200 in the years 2010–2011 and 200 in 2014–2015. The Swedish national recommendations for antibiotic prophylaxis were published in 2012. Results: There was a wide variation in antibiotic regiments prescribed throughout the study. The number of patients treated with antibiotic prophylaxis in a single dose of 2 g amoxicillin, and treated as advocated in the national recommendations, was low and decreasing between the two time periods from 25% (n = 50/200) in 2010–2011 to 18.5% (n = 37/200) in 2014–2015. The number of patients not given any antibiotics either as a prophylactic single dose or during the postoperative phase increased (P < 0.001). The administration of a 3-7-days antibiotic prescription increased significantly from 25.5% in 2010–2011 to 35% in 2014–2015. The postoperative infection rates (4.5% and 6.5%) were without difference between the studied periods. Smoking and omitted antibiotic prophylaxis significantly increased the risk of postoperative infection. Logistic regression analyses showed that patient male gender and suffering from a disease were predictive factors for the clinician to adhere to the guidelines. Conclusions: After introduction of national recommendations for antibiotic prophylaxis before bone augmentation procedures, the patient group receiving a single preoperative dose decreased while the group not given antibiotic prophylaxis increased. There was no difference in occurrence of postoperative infections between the two time periods. The results indicate a need for educational efforts and strategies for implementation of antibiotic prudence and awareness among surgeons performing bone augmentation procedures. [ABSTRACT FROM AUTHOR]

Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long‐term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post‐extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low‐substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed. [ABSTRACT FROM AUTHOR]

Bone augmentation has become a routine procedure to enhance and/or repair a deficient or resorbed alveolar ridge for predictable and successful implant placement. The split expansion ridge i.e., the alveolar ridge splitting (ARS) procedure, is one of the less invasive procedures, and is characterized by minor morbidity. This would allow to widen narrow ridges in order to allow implant reconstruction in a sufficient bone volume. Its efficacy and long‐term stability rely upon clinical opinions and long‐term retrospective studies, while prospective comparative studies and randomized controlled trials are rare. This critical review presents the development of this technique, describes the surgical procedure, and provides technical notes and modifications. The learning curve and in‐depth knowledge of the oral anatomy, as well as the recognition of incidence and management of complications are of utmost importance in the clinical application of the ARS procedure. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to evaluate the amount of crestal bone remodeling in polished collar implants. METHODOLOGY: Thirty patients with a missing maxillary or mandibular 1st or 2nd premolar tooth requiring simultaneous bone grafting were recruited and implant placed at the level of crest with polished collar placed 1mm apical to the level of bone and bone augmentation was performed to graft the buccal threads. Buccal bone thickness was measure at crestal level as well as 1mm apical to polished collar. The implants were uncovered at 6 months and restored and patients followed up for 12 months from the time of implant placement. Cone beam computed tomography scans were taken at two time points, immediately after implant placement and at 12-month time point. RESULTS: At clinical re-entry (6 months), there was significant difference in mean buccal bone thickness found between crestal level and 1mm apical to polished collar (p<0.05). Radiographically (at 12 months), the mean buccal bone change was -1.82mm 0.57mm at crest and -0.94mm 0.31mm at 1mm apical to crest. CONCLUSION: Bone regenerative techniques were unable to prevent biologic bone remodeling around the implant platform; therefore, the outcomes of bone augmentation might be affected by the polished collar of implant. [ABSTRACT FROM AUTHOR]

Introduction: Bone augmentation procedures are established tools for reshaping the alveolar ridge and increasing bone volume. Different approaches are being used to measure postoperative bone volume gain. This study aimed to develop an objective and automated volume measurement tool equally as precise as manual slice-by-slice annotation. Materials and methods: To evaluate the proposed workflow, we performed an in vitro study with 20 pig mandibles that were grafted using three different grafting techniques—autogenous full block, split block bone and shell augmentation. The pig jaws were scanned pre- and postoperatively using an intraoral scanner. The resulting surface files (baseline, full block, split block, shell) were processed using the new volume-measuring workflow as well as using manual slice-by-slice annotation at baseline (t0) and at 6 months (t1) using the same population. Two TOSTs (Test of One-Sided Significance) and NHSTs (Null Hypothesis Significance Test) were used to compare the two workflows. The intra-rater reliability between t0 and t1 was determined using intraclass correlation coefficients. Results: The mean difference for the full block augmentation technique was − 0.015 cm3 (p < 0.001); for the split block technique, it was − 0.034 cm3p = 0.01, and for the shell technique, it was − 0.042 cm3. All results were statistically not different from zero and statistically equivalent to zero. The results also showed an excellent absolute intra-rater agreement. Conclusions: The semiautomatic volume measurement established in this article achieves comparable results to manual slice-by-slice measuring in determining volumes on STL files generated by intraoral scanners and shows an excellent intra-rater reliability. [ABSTRACT FROM AUTHOR]

Objectives: The aims of Working Group 1 were to address the role (i) of the buccolingual bone dimensions after implant placement in healed alveolar ridge sites on the occurrence of biologic and aesthetic complications, and (ii) of soft tissue augmentation (STA) on the stability of clinical, radiographic, and patient‐related outcomes of implant treatments. Materials and Methods: Two systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, recommendations for future research, and reflections on patient perspectives were based on structured group discussions until consensus was reached among the entire group of experts. The statements were then presented and accepted following further discussion and modifications as required by the plenary. Results: Dimensional changes of the alveolar ridge occurred after implant placement in healed sites, and a reduction in buccal bone wall thickness (BBW) of 0.3 to 1.8 mm was observed. In healed sites with a BBW of <1.5 mm after implant placement, increased vertical bone loss, and less favorable clinical and radiographic outcomes were demonstrated. Implants with buccal dehiscence defects undergoing simultaneous guided bone regeneration, showed less vertical bone loss, and more favorable clinical and radiographic outcomes, compared to non‐augmented dehiscence defects during initial healing. At healthy single implant sites, probing depths, bleeding and plaque scores, and interproximal bone levels evaluated at 1 year, remained stable for up to 5 years, with or without STA. When single implant sites were augmented with connective tissue grafts, either for soft tissue phenotype modification or buccal soft tissue dehiscence, stable levels of the soft tissue margin, and stable or even increased soft tissue thickness and/or width of keratinized mucosa could be observed from 1 to 5 years. In contrast, non‐augmented sites were more prone to show apical migration of the soft tissue margin in the long‐term. Favorable aesthetic and patient‐reported outcomes after STA were documented to be stable from 1 to 5 years. Conclusions: It is concluded that dimensional changes of the alveolar ridge occur after implant placement in healed sites and that sites with a thin BBW after implant placement are prone to exhibit less favorable clinical and radiographic outcomes. In addition, it is concluded that STA can provide stable clinical, radiographic, aesthetic, and patient‐reported outcomes in the medium and long‐term. [ABSTRACT FROM AUTHOR]

Bone grafting for implant dentistry depends on bone quality, quantity, and biological principles for good outcome. Autogenous bone as donor remains the gold standard among all the available materials. However, it carries unpredictable morbidity and need for different surgical sites. In our report, we describe a simplified approach in bone augmentation for restricted maxillary atrophic defect within the same surgical site as a harvesting site. The method can be an alternative for different intraoral surgical harvesting sites. The patient's left maxillary central incisor before treatment had a large bony defect which was reconstructed though single site approach of augmentation. The implant-supported restoration with healthy periodontium around even after 2 years of review looks promising. The approach can be an alternative for different intraoral surgical sites. [ABSTRACT FROM AUTHOR]

To evaluate the formation of reactive oxygen species in human leukocytes promoted by bone substitutes that are different in origin and morphology used for jawbone tissue regeneration. Materials and Methods: This preclinical prospective randomized crossover study involved 10 subjects, from whom venous blood samples were taken. Leukocytes were separated and standardized. Sixty experimental samples consisted of leukocytes incubated with allogeneic, xenogeneic, or alloplastic bone substitutes at different bone weights (12.5 and 25 mg). The control samples consisted only of incubated leukocytes. Reactive oxygen species were quantitatively determined with the fluorimetric method. Statistical analysis was carried out using SPSS 23 software. Results: The highest average reactive oxygen species values were obtained in the allogeneic bone substitute group (P < .05), while the xenogeneic bone substitute group and control group presented equal reactive oxygen species formation rates (P > .05). A proportional difference (P < .05) of reactive oxygen species emission was obtained between different masses of bone substitute in the samples. Conclusion: Allogeneic and alloplastic bone substitutes affect leukocytes and promote reactive oxygen species emission. Xenogeneic bone substitute presents no leukocyte stimulation and maintains anti-inflammatory conditions. Larger bone substitute mass provokes greater oxidative stress. [ABSTRACT FROM AUTHOR]

The objectives of this retrospective study were to describe a transcrestal sinus floor elevation technique combining the use of a hydraulic device and a nanohydroxylapatite paste and to report on 4-year clinical and radiographic outcomes. Materials and Methods: The sinus floor elevation procedure used a specially designed drill (SinusJet) to start sinus membrane unsticking and a nanohydroxylapatite paste (Ostim) for further sinus membrane elevation and bone augmentation. It was performed as a one-step procedure with immediate implant placement or a two-step procedure with delayed implant placement 9 months later. Implant survival rate, sinus membrane perforation, postoperative complications, and the level of intraoperative and postoperative patient comfort using a visual analog scale were analyzed retrospectively. A nonparametric Wilcoxon matched-pairs test and parametric paired t test were used to identify significant differences. Results: One hundred thirty-six sinus floor elevations were performed in 110 patients at two dental clinics in Belgium with a mean follow-up period of 48 months. In the one-step procedure, the mean 6-month elevation was 8.5 ± 2.7 mm; 194 implants were placed. In the two-step procedure, the mean 9-month elevation was 9.5 ± 2.4 mm; 8 implants were placed. The osteotomy, sinus membrane elevation, and bone grafting typically took less than 3 minutes. Sinus membrane perforation was observed in 2.9% (n = 4/136). The 4-year implant survival rate was 97% (n = 196/202), with six early implant losses. 96.4% of patients reported either no or minimal discomfort. Conclusion: This minimally invasive transcrestal sinus floor elevation procedure that combines a hydraulic device and nanohydroxylapatite paste appears to be safe and predictable. However, further randomized controlled studies are needed to validate the results of this retrospective observational study. [ABSTRACT FROM AUTHOR]

Abstract Background Resorption of alveolar bone is a common sequela of tooth loss and presents a clinical problem, especially in the esthetic zone. When ridge resorption occurs, adequate bone augmentation is essential to obtain satisfactory esthetic results. The purpose of this study was to determine the increase and retention rate of bone height or width in patients who received extensive bone augmentation and to analyze factors affecting its prognosis and stability. Methods This study was performed on patients who received extensive bone augmentation by sausage technique at the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mok-dong Hospital from January 1, 2018, to February 28, 2022. CBCT images were taken before and 6 months after surgery to compare the amount of increase in bone height or width at the graft site. They were measured using reliable points such as adjacent implants or cephalometric landmarks, inferior alveolar nerve canals as reference points. Results A total of 8 patients underwent extensive bone grafting during the given period (mean age was 53.75 years, 2 males and 6 females). Four patients received horizontal augmentation, and 4 received vertical augmentation. When divided by surgical site, 4 patients are in maxilla and 4 in mandible. The average amount of increase in bone width or bone height was 5.38 mm, and the retention rate was about 79.9% after 6 months. The retention rate of horizontal augmentation was 88.8%, which was higher than that of vertical augmentation, which was 74.5%. The maxillary area accounted for 92.2%, and the amount of bone resorption was lower than that of the mandibular area, which was 72.6%. The average stitch out period was about 2.4 weeks, and postoperative dehiscence was observed about 37.5% of the total, more frequently in the mandible (50.0%) than in the maxilla (25.0%). Conclusion In conclusion, extensive bone augmentation achieved significant horizontal or vertical bone height or width increase, and the retention rate after 6 months was also high. In addition, surgery in the maxillary region showed a more successful bone augmentation than in the mandible, with a higher maintenance rate and fewer cases of dehiscence.

Purpose: Intraoral bone blocks from the external oblique are the gold standard for alveolar ridge bone grafting, but the limited amount of available bone limits their use for larger defects. The objective of this study was to compare whether different graft designs of intraoral bone blocks could affect the amount of bone gain. Materials and Methods: In this in vitro study, 20 pig jaws were used to harvest bone blocks and subsequently augment single-wall bone defects. Each bone graft was first used as a full block, and then the same block was divided lengthwise into two blocks, with one block fixed at a distance as a cortical shell and the second block particulated to fill the gap between graft and bone. Three stereolithographic (STL) files (pre-OP, full block, split block) were generated using an intraoral scanner. All STL files were evaluated for volume gain and horizontal bone dimensions. Results: A mean volume gain of 0.36 cm2 (SD: 0.09) was achieved for the full block and 0.78 cm2 (SD: 0.14) for the split block using the same block. The difference was statistically significant (P < .0001). A mean horizontal bone gain of 4.37 mm (SD: 0.93) was achieved with a full block and 5.77 mm (SD: 0.85) with the shell technique (P < .0001). Conclusion: With the same amount of bone removed, first as a full block and then as a split block, the split-block technique achieved a significantly higher bone gain compared with the full-block design. [ABSTRACT FROM AUTHOR]

Objectives: In the present pilot, multicenter, randomized, single- blinded, controlled study, surgical treatment with or without the administration of D-PLEX500 (a biodegradable prolonged release local doxycycline formulated with β-tricalcium phosphate bone graft) was accessed for the treatment of peri-implantitis. Method and materials: Subjects undergoing surgical treatment for intrabony peri-implantitis defects after flap elevation were randomly assigned, to adjunct D-PLEX500 placement group or to control group. Clinical and radiographic parameters were measured at 6 and 12 months. Results: Twenty-seven subjects (average age: 64.81 ± 7.61 years) were enrolled; 14 patients (18 implants) were randomized to the test group and 13 (14 implants) to the control group. There was no difference in plaque scores between the groups. There was no difference in the changes of mean periodontal probing depth between the test and control groups between baseline and the 6-month follow-up, whereas statistically significant difference was observed after 12 months' follow- up when analyzed for all sites averaged. There was a statistically significant difference in the changes of clinical attachment levels and radiographic bone levels between the groups between baseline and 12 months. These improvements were demonstrated when analyzed at both implant and subject levels. Only D-PLEX500 treatment led to improved bone levels at both time points. The improvement in bone levels was significant in the D-PLEX500 treatment group already after 6 months, and further improved over the 12-month follow-up. Implants were lost only in the control group (14%). Conclusions: D-PLEX500 sustained release local antibiotic formulated with bone filler showed promising results in enabling healing of peri-implantitis lesions. The antibacterial component of the bone graft material might create favorable conditions that enable implant surface decontamination and soft and hard tissue healing over a prolonged period. [ABSTRACT FROM AUTHOR]

Purpose: Bone regeneration procedures are often evaluated based on biologic aspects only. As regenerated bone also has to ensure primary implant stability, the goal of this study was to determine the mechanical quality of regenerated bone. Materials and Methods: Six adult minipigs were allocated for this experiment with four mandibular study sites each established following tooth removal. Two different types of bovine bone mineral as well as autogenous bone were used for augmenting three-walled defects, while native bone served as the control. Implants were placed after 12, 18, and 24 weeks of healing, and bone quality was determined using intraoperative compressive testing (BoneProbe), insertion torque measurements, and resonance frequency analysis. The mandibles were then harvested for determining bone mineral density (BMD) and bone-to-implant contact (BIC). Statistical analysis was based on two-way analysis of variance of aligned rank transformed data and Spearman's rank correlation tests (a = .05). Results: The effects of the factors healing time and material on the parameters tested were too small to be significant (P ranging from .34 to .98). Weak correlations were observed for implant insertion torque with BoneProbe measurements in the cortical (0.481; P = .032) and in the trabecular area (0.639; P = .002). BoneProbe measurements in the trabecular part and in the cortical part also correlated with each other (0.477; P = .035). Conclusion: While differences may exist between bone regenerated using different biomaterials with respect to biologic behavior, differences in the mechanical properties determining primary implant stability seem to be minor. Implant insertion torque measurements appear to be a reliable tool for determining bone quality if only one specific implant type is considered. [ABSTRACT FROM AUTHOR]